%PDF-1.4
%
41 0 obj
<>
endobj
38 0 obj
<>
endobj
121 0 obj
<>stream
Acrobat Distiller 4.05 for Macintosh
2004-12-09T11:38:36Z
2024-03-28T11:27:38-07:00
QuarkXPressª: AdobePS 8.8.0 (301)
2024-03-28T11:27:38-07:00
application/pdf
Heather
2004-164.jan
uuid:8b431825-1dd2-11b2-0a00-6408271d5700
uuid:8b431828-1dd2-11b2-0a00-bf0000000000
endstream
endobj
27 0 obj
<>
endobj
28 0 obj
<>
endobj
42 0 obj
<>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/Thumb 15 0 R/Type/Page>>
endobj
1 0 obj
<>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/Thumb 17 0 R/Type/Page>>
endobj
4 0 obj
<>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/Thumb 19 0 R/Type/Page>>
endobj
7 0 obj
<>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/Thumb 21 0 R/Type/Page>>
endobj
138 0 obj
[143 0 R]
endobj
139 0 obj
<>stream
1 g
/GS0 gs
0 792 m
0 792 l
f
q
13.5 787.5 585 -783 re
W n
q
0 792.03 612 -792 re
W n
BT
0 0 0 1 k
/GS1 gs
/T1_0 1 Tf
-0.00011 Tc 0.0136 Tw 10 0 0 10 54 734.8264 Tm
(concomitant cryptococcemia appear to indicate risk of mor-)Tj
0.02499 Tw 0 -1.2 TD
(tality in patients with SLE.)Tj
-0.0174 Tw 1.2 -1.2 Td
(The second most common pathogen of CNS infections in)Tj
0.0184 Tc 0.35651 Tw -1.2 -1.2 Td
(SLE patients was )Tj
/T1_1 1 Tf
(L. monocytogenes)Tj
/T1_0 1 Tf
[-0.4 (, an intracellular)]TJ
-0.00011 Tc 0.2374 Tw T*
(pathogen capable of spreading directly from cell to cell)Tj
0.0528 Tw T*
(without exposure to the extracellular humoral immune sys-)Tj
-0.00031 Tc 0 Tw T*
(tem)Tj
0 Tc 7.5 0 0 7.5 68.9951 666.1265 Tm
(15)Tj
-0.00011 Tc -0.0164 Tw 10 0 0 10 76.4951 662.8264 Tm
(. Resistance to infection with )Tj
/T1_1 1 Tf
11.8035 0 Td
(L. monocytogenes )Tj
/T1_0 1 Tf
7.4373 0 Td
(is pre-)Tj
0.17281 Tw -21.4902 -1.2 Td
(dominantly cell-mediated)Tj
0 Tc 0 Tw 7.5 0 0 7.5 158.1912 654.1265 Tm
(16)Tj
-0.00011 Tc 0.17281 Tw 10 0 0 10 169.919 650.8264 Tm
[(and depletion of CD4 )18 (T)-405 (cells)]TJ
0.09351 Tw -11.5919 -1.2 Td
(could play a role in the pathogenesis of )Tj
/T1_1 1 Tf
16.6866 0 Td
(L. monocytogenes)Tj
/T1_0 1 Tf
-0.0036 Tc 0 Tw -16.6866 -1.2 Td
[(inf)-4 (ections)]TJ
-0.005 Tc 7.5 0 0 7.5 93.0789 630.1265 Tm
(17)Tj
-0.0051 Tc 0.18291 Tw 10 0 0 10 100.5039 626.8264 Tm
(. Patients with SLE often receive immunosup-)Tj
0.0544 Tw -4.6504 -1.2 Td
[(pressive agents and have abnormal cell-mediated immunity)65 (,)]TJ
-0.01511 Tw T*
(and are therefore susceptible to )Tj
/T1_1 1 Tf
(L. monocytogenes )Tj
/T1_0 1 Tf
0 Tw 19.8571 0 Td
(infections.)Tj
-0.0051 Tw -19.8571 -1.2 Td
[(Their prognoses are also poor)40 (, as seen in our review: 2 of the)]TJ
0.02499 Tw T*
[(4 patients died despite appropriate antibiotic therapy)65 (.)]TJ
-0.00011 Tc -0.01559 Tw 1.2 -1.2 Td
(Other pathogens in the bacterial meningitis group includ-)Tj
-0.0002 Tc 0 Tw -1.2 -1.2 Td
(ed)Tj
/T1_1 1 Tf
0 Tc 0.1171 Tw 1.311 0 Td
(S. pneumoniae)Tj
/T1_0 1 Tf
-0.00011 Tc 0 Tw 6.3718 0 Td
(and )Tj
/T1_1 1 Tf
0.1172 Tw 1.811 0 Td
[(E. aer)37 (ogenes)]TJ
/T1_0 1 Tf
0.0623 Tw 5.3005 0 Td
[(. Although )-55 (Salmonella)]TJ
0.0052 Tw -14.7943 -1.2 Td
(species are among the most common opportunistic bacterial)Tj
0.0269 Tw T*
(infections seen in fatal SLE)Tj
0 Tc 0 Tw 7.5 0 0 7.5 165.5881 534.1265 Tm
(2)Tj
-0.00011 Tc 0.02699 Tw 10 0 0 10 169.3381 530.8264 Tm
(, no salmonella meningitis was)Tj
0.0961 Tw -11.5338 -1.2 Td
(identified among our patients. Salmonella meningitis is an)Tj
0.0031 Tc 0.3718 Tw T*
(unusual complication of Salmonella sepsis and occurs)Tj
-0.00011 Tc 0.0563 Tw T*
(almost exclusively in infants and young children. It is very)Tj
0.02499 Tw T*
(rare in adults, even in patients with SLE.)Tj
0.16991 Tw 1.2 -1.2 Td
(Based on our findings, we suggest that once a patient)Tj
0.047 Tw -1.2 -1.2 Td
(presents with symptoms of CNS infection and signs of ele-)Tj
0.13631 Tw T*
[(vated CRP)111 (, CSF analysis should be performed as soon as)]TJ
0.0152 Tw T*
(possible because an accurate diagnosis is crucial to survival)Tj
0.16479 Tw T*
(of the patient. Because of the prevalence of cryptococcal)Tj
0.06 Tw T*
(meningitis, an India ink stain and cryptococcal antigen test)Tj
0.09641 Tw T*
(should be performed on the initial CSF specimen in every)Tj
0.22321 Tw T*
(patient to ensure the earliest diagnosis possible. Patients)Tj
0.16389 Tw T*
(with high cryptococcal latex agglutination titers and con-)Tj
0.0974 Tw T*
[(comitant cryptococcemia appear to be prone to death. )18 (The)]TJ
0.35339 Tw T*
(duration of antifungal therapy remains controversial in)Tj
0.1088 Tw T*
(patients with SLE and further study is needed to optimize)Tj
0 Tw T*
[(therapy)65 (.)]TJ
/T1_2 1 Tf
0 -2.4 TD
(REFERENCES)Tj
/T1_0 1 Tf
0.02499 Tw 8 0 0 8 61 292.8264 Tm
[(1.)-875 (Marcela J, Richard MD, Graciela SA. Infection in systemic )]TJ
1.675 -1.25 Td
(connective tissue diseases: systemic lupus erythematosus, )Tj
0 -1.25 TD
(scleroderma, and polymyositis/dermatomyositis. Rheum Dis Clin)Tj
0 Tc -0.02991 Tw T*
[(North Am )-55 (2003;29:163-84.)]TJ
-0.00011 Tc 0.02499 Tw 31.325 59.171 Td
[(2.)-875 (T)70 (sao CH, Chen CY)129 (, Ou LS, Huang JL. Risk factors of mortality for)]TJ
1.675 -1.25 Td
(Salmonella infection in systemic lupus erythematosus. J Rheumatol)Tj
0 Tc 0 Tw T*
(2002;29:1214-8.)Tj
-0.00011 Tc 0.02499 Tw -1.675 -1.25 Td
[(3.)-875 (W)40 (u KC, )37 (Y)100 (ao )18 (TC, )37 (Y)100 (eh KW)92 (, Huang JL. Osteomyelitis in patients)]TJ
1.675 -1.25 Td
(with systemic lupus erythematosus. J Rheumatol 2004;31:1340-3.)Tj
-1.675 -1.25 Td
[(4.)-875 (Petri M. Infection in systemic lupus erythematosus. Rheum Dis)]TJ
1.675 -1.25 Td
[(Clin North )55 (Am 1998;24:423-56.)]TJ
-1.675 -1.25 Td
[(5.)-875 (Duf)18 (fy KN, Duf)18 (fy CM, Gladman DD. Infection and disease activity)]TJ
1.675 -1.25 Td
(in systemic lupus erythematosus: a review of hospitalized patients.)Tj
T*
[(J Rheumatol 1991;18:1)37 (180-4.)]TJ
-1.675 -1.25 Td
[(6.)-875 (Paton NI, Cheong IK, Kong NC, Segasothy M. Risk factors for)]TJ
1.675 -1.25 Td
(infection in Malaysian patients with systemic lupus erythematosus.)Tj
0 Tc T*
(Q J Med 1996;89:531-8.)Tj
-0.00011 Tc -1.675 -1.25 Td
[(7.)-875 (Gladman DD, Hussain F)80 (, Ibanez D, Urowitz MB. )18 (The nature and)]TJ
1.675 -1.25 Td
(outcome of infection in systemic lupus erythematosus. Lupus)Tj
0 Tw T*
[(2002;1)37 (1:234-9.)]TJ
0.02499 Tw -1.675 -1.25 Td
[(8.)-875 (Zonana-Nacach )55 (A, Camar)18 (go-Coronel )55 (A, )37 (Y)100 (anez P)111 (, Sanchez L,)]TJ
1.675 -1.25 Td
[(Jimenez-Balderas FJ, Fraga )55 (A. Infections in outpatients with )]TJ
T*
[(systemic lupus erythematosus: a prospective study)65 (. Lupus)]TJ
0 Tc 0 Tw T*
(2001;10:505-10.)Tj
-0.00011 Tc 0.02499 Tw -1.675 -1.25 Td
[(9.)-875 (Shyam C, Malaviya )55 (AN. Infection-related morbidity in systemic)]TJ
1.675 -1.25 Td
(lupus erythematosus: a clinico-epidemiological study from northern)Tj
T*
(India. Rheumatol Int 1996;16:1-3.)Tj
-2.175 -1.25 Td
[(10.)-875 (T)70 (an EM, Cohen )55 (AS, Fries JF)80 (, et al. )18 (The revised criteria for the )]TJ
2.175 -1.25 Td
[(classification of systemic lupus erythematosus. )55 (Arthritis Rheum)]TJ
0 Tc 0 Tw T*
(1982;25:1271-7.)Tj
-0.00011 Tc 0.02499 Tw -2.1381 -1.25 Td
[(1)37 (1.)-875 (Bombardier C, Gladman DD, Urowitz MB, Caron D, Chang CH.)]TJ
2.1381 -1.25 Td
[(The Committee on Prognosis Studies in SLE. )18 (The development and)]TJ
T*
[(validation of the SLE Disease )55 (Activity Index \(SLEDAI\). )55 (Arthritis)]TJ
0 Tc T*
(Rheum 1992;35:630-40.)Tj
-2.175 -1.25 Td
[(12.)-875 (Shih CC, Chen )37 (YC, Chang SC, Luh KT)74 (, Hsieh )18 (WC. Cryptococcal)]TJ
-0.00011 Tc 2.175 -1.25 Td
[(meningitis in non-HIV)92 (-infected patients. Q J Med 2000;93:245-51.)]TJ
-2.175 -1.25 Td
[(13.)-875 (Gottfredsson M, Perfect JR. Fungal meningitis. Semin Neurol)]TJ
0 Tc 0 Tw 2.175 -1.25 Td
(2000;20:307-22.)Tj
-0.00011 Tc 0.02499 Tw -2.175 -1.25 Td
[(14.)-875 (Zimmermann B 3rd, Spiegel M, Lally E. Cryptococcal meningitis)]TJ
2.175 -1.25 Td
[(in systemic lupus erythematosus. Semin )55 (Arthritis Rheum)]TJ
0 Tc 0 Tw T*
(1992;22:18-24.)Tj
-0.00011 Tc 0.02499 Tw -2.175 -1.25 Td
[(15.)-875 (Southwick FS, Purich DL. Intracellular pathogenesis of listeriosis.)]TJ
0 Tc 2.175 -1.25 Td
(N Engl J Med 1996;334:770-6.)Tj
-0.00011 Tc -2.175 -1.25 Td
[(16.)-875 (Quagliarello )18 (VJ, Scheld )18 (WM. Bacterial meningitis: Pathogenesis,)]TJ
2.175 -1.25 Td
[(pathophysiology)65 (, and progress. N Engl J Med 1992;327:864-72.)]TJ
-2.175 -1.25 Td
[(17.)-875 (Anaissie E, Kontoyiannis DP)111 (, Kantarjian H, Elting L, Robertson)]TJ
2.175 -1.25 Td
(LE, Keating M. Listeriosis in patients with chronic lymphocytic)Tj
T*
[(leukemia who were treated with fludarabine and prednisone. )55 (Ann)]TJ
T*
[(Intern Med 1992;1)37 (17:466-9.)]TJ
ET
0 0 0 1 K
53.468 76.5 m
558.468 76.5 l
S
0 0 0 0 k
494.29 69.365 64.178 -15.665 re
f*
BT
0 0 0 1 k
/T1_1 1 Tf
0 Tc 0 Tw 8 0 0 8 549.468 56.4344 Tm
(43)Tj
ET
0 0 0 0 k
53.532 70.5 203 -16.86 re
f*
BT
0 0 0 1 k
/T1_1 1 Tf
-0.00011 Tc 0.02499 Tw 8 0 0 8 54.532 56.374 Tm
(Hung, et al: CNS infections in SLE)Tj
ET
0 0 0 0 k
/GS0 gs
102.631 81.583 407.5 -10.833 re
f*
0.5 w
/GS1 gs
102.631 81.583 407.5 -10.833 re
S
Q
Q
q
0 0 612 792 re
W n
BT
0 g
ET
/GS2 gs
BT
/T1_3 8 Tf
106.328 74 Td
(Personal non-commercial use only. The Journal of Rheumatology Copyright\
\251 2005. All rights reserved.)Tj
ET
Q
BT
0 g
/GS3 gs
/T1_4 1 Tf
10 0 0 10 540 17 Tm
( )Tj
0 0.48627 0.77255 rg
/GS3 gs
-7.22298 0 Td
(www.jrheum.org)Tj
0 g
/GS3 gs
-16.72996 0 Td
(Downloaded on March 28, 2024 from )Tj
ET
endstream
endobj
21 0 obj
<>stream
8;Z\7JSmgu#k\.Hd,.u-i;arJ>.5f9A8.OaLNa!_Xk"Hk.*=6tMYA<@V^GehQ%!)q
Y!)UZZ2GE[e0TIW#bc`?Egage1ZD=Uf:-L#:b,`iLpEm@9kmZMG=53XOXk+AY<*(^
6VJaF9#%lW8C)6khm6;G[NW`e#>!b#H`^Iu85AbkXE0DqC+9se61rV<\$[p"*r'sh
'VhfglIfENFA%W:kIqb;!,mD2)aZ,NGDI6$'-'e;3q"%%O]*N`9VH8Xe?M>_RY4P@
'[,o(#$910!%huYW8hJaIH7JP;&?"Z?lb8(H[=dGU8eHHM"$X#&Rto5fQGCf
9DuWbGf_Udr]5ck-Hjp'@n)H2~>
endstream
endobj
25 0 obj
[/Indexed/DeviceRGB 255 24 0 R]
endobj
24 0 obj
<>stream
J,g]g+e/h_!_gCtO=0f)$P%cIi8Zdfc5&3j_8$7g.@L`YKUJNGBP\poR=_;Dl'P(T
(7Boo^^S:71(MN]ZQX/+Cbu.lK"p74pe1T%s.DY%&\1TdJhr54.M9au6>79n6`Q:4
PbLSZTLEE(8E@'*1mg_*eTnN*;*'V3+gm-EEetX%;Bo$ur2ss*N`.-!.kG_q6GDD'
dKoL!8Ka#EV,@V!\j8ZFbp6EE<9cn=N6j0nf;(&;QU6bUD')c@\
9-d\DA=cZ0Q>gIM$$;cd2O@&a;X,Nn_aP(]I1aRc(K1^ue>
gF/(+GaKo$qneLWDrQ#;5\S(\$q'4Q,85`-8;S(=Z"WSBOV*FM)4,?B],R
endstream
endobj
48 0 obj
<>
endobj
46 0 obj
<>
endobj
66 0 obj
<>
endobj
83 0 obj
<>
endobj
127 0 obj
<>
endobj
65 0 obj
<>
endobj
78 0 obj
<>stream
HLPw9v_lEY=I1WCiB$(ĉs./;,h=8Dh t@-"iI'&U84Ϯ]<μ}DxAdTfڜUY6XlfWlZ&FBGdN'9x?z⎐i5:"(8(?dq\\*RUR&<_#,INAkVㄴ"VUfL{Ct:DSh YB%]fB=}TP&6X*8,QV4i/ &{ыQ\[]"I]?\>z4AA,1$#Yꈈp&bK֑߇m {?.KץSpҩP^}_w:%C2l?abhЖZm5W-7ȶ=6A9Rڛd߮j
'(?{}Ȑ$^0,NJ4ZW44B43$wޭpn%F\8@Nj~uW5'NR=HX[446q8H}L3Dtv͆An{X/b8g4nvlûm;7{Ы~P @Kclȃ^r/(i-Z-ytcwmtqۢBFkW
Nu J:WpwI! e'XF՚|HW/Zg#ӔHQC122=?4]?WI|U".^(D"=ES&[ -n|M]_$HTLK
ouCAᔈ~VTEh
M_!!q*Q6iLO/7
}SwU9vɶ(_Gzc|^=`lt7xAވo+ҟմUƆhݎJj -zљv_f&RY^,Qw7 `[[Ӛ*O bO%膷_#_9o]e:vc>>$dO*N8z)8;oC)X
p<bB0O,bxGZրVR=zF_}3y?kUum<.CS=4܀)ERm?
e߸}/RGrGBӳ]
&ZT3lOn7j Z{FlSSSUfܷ|sx^vA ROJ+!쎚q$:y;tӭ
mGz-2B8k S.[(Zb{eceqZGd_7%CZ+x;ЧS5eݴ
=ڇnX6x!"ԁ]tm
{.(DNI2`Hߪmd2ZDZm-Zf袷ӟ%\ƱۇG>[3hhV4y/T^[FKɮ&YỤ?UWg+[
` k
endstream
endobj
49 0 obj
<>
endobj
76 0 obj
<>stream
HT{PSg˽ "`,Jݩ""]DD y
!0̍8+B0l5삭S}ec
wã>%
a"@Iq9e\kNNgx(썴7ƝC.K
ω3mĝvad<-/x{5g- CO75Ԋ<2(U%7ryQ# :rMy2C'h(S8'n%֎EDPH|ym;pnsWg7`bGI5G,_9u1 2}t _i|Neښ!]mGM4y+M݀vbЈI5Vewґ1Բmnq,e?\K9m =|Oאz"+đȡFU7jz:Nް4|%jܿ>>o>|'p8ptcCM%˳mtUa|E8W_5 #Xw2sSViMbM*P3XX'6LYg+Хn6dL@v
?L*eP2j?u#(0O
'QT8d/a&OL":-Ѯ[5Z%Jm8ÜgެZt7PQzZN뼘yK#4n{{ÊA'lĤd ]RhQuҸuE."|6oQ$5|йr;{ZLcCV]>qK5[Z\Qk| ƄMVHw?t%p7q@a u ^ӮEߡMۍe^̸,oa8.d0NOisWo w1aiF@K*DJ[T/f
4idTVF|+%T6NFE`'WGmp 7#ؿ+iPtrZ
}sbLZM.mw]